Exploration of Problems and Restrictions in Preventive System for Repeated Drug Allergy in the Network of Healthcare Providers at Khunyhum District, Mea Hong Son

Abstract

Objective: To explore problems and restrictions in preventive system for repeated drug allergy in patients receiving care outside their service area in health provider network at Khunyhum District, Mea Hong Son Province. Method: The study was a qualitative study conducted during April to November, 2018. Informants were purposively sampled, and consisted of 11 healthcare providers within the Network including one physician, 2 practicing pharmacists, one nurse at the screening point, 2 nurses in sub-district health promoting hospitals, 2 public health officers, one medical record officer and two computer technical officers. The study collected the data on work flow of the involved officers and practitioners, and problems in preventive system for repeated drug allergy by interview, observation and focus group discussion in order to draw the conclusion in the procedure for preventive system for repeated drug allergy. Results: Problems and restrictions in the present preventive system for repeated drug allergy were resulted from patients’ unclear notification of history on drug allergy and incomplete transfer of history on drug allergy among different health institutions at all levels at the district and provincial level. The strength within hospitals and sub-district health promoting hospitals was the emphasis on development of database within electronic medical records. However, the weakness was delay in the transfer of history on drug allergy and no exchange of history on drug allergy among health institutions. Regarding the establishment of the preventive system within health provider network at Khunyhum District, focus group discussion reached the consensus that the present system was working well, health practitioners were able to follow all procedures of the system, but there was no exchange of medical information. Literature review on of information system for preventing repeated drug allergy, data management system in Thailand revealed that exchange of medical information through PHR Search was an appropriate approach for preventing repeated drug allergy, and had a highest possibility for further developing the system in Khunyhum District. Additional work process under need was the examination of history on drug allergy and drug history in patients with suspected sensitivity. Conclusion: The major problems and restrictions in preventive system for repeated drug allergy were the differences of the database in electronic medical records of each hospital, making it difficult to use data to monitor repeated drug allergies of patients receiving care across the service area. In this study, the problems and restrictions were resolved by using data on patient history from the provincial level database to additionally identify drug allergy to cover the transmission of medical information among health providers within the Network, service providers at the provincial level, and at neighboring provinces. However, there should be an evaluation of the implementation of the use of the repeated drug allergy monitoring system in order to obtain a guideline that is practical and can be a model for preventing drug allergy or preventing other adverse events in Thailand.